WO2015044926A1

WO2015044926A1 - Audiometry system and method

Info

Publication number: WO2015044926A1
Application number: PCT/IB2014/064944
Authority: WO
Inventors: De Wet SWANEPOEL; Herman Myburgh
Original assignee: University Of Pretoria
Priority date: 2013-09-30
Filing date: 2014-09-30
Publication date: 2015-04-02
Also published as: AP2016009126A0; ZA201602129B

Abstract

The invention provides an audiometry system for performing a mobile hearing screening, and a method for performing said screening. The system comprises a mobile device for transmitting a plurality of different predetermined signals representing predetermined sounds of different frequency and intensity; at least one set of earphones provided with a receiver for receiving the signals, the earphones being responsive to the signals for emitting said predetermined sounds in accordance with the signals; and an interface programmed to determine and record the response of a user of the earphones to the emission of the respective sounds by the earphones in response to the signals.

Description

AUDIOMETRY SYSTEM AND METHOD

INTRODUCTION AND BACKGROUND

This invention relates to an audiometry system, and more particularly, but not exclusively, to an audiometry system for performing a mobile hearing screening, and a method for performing said screening.

All formal learning activities in typical school environments are at least partially mediated through the sense of hearing. Any loss in hearing sensitivity therefore constitutes a major and often insurmountable barrier to effective learning, especially if it is not detected at an early stage.

According to the World Health Organisation, children with hearing loss are at risk for delayed speech, language and cognitive skills, which translates to reduced literacy, academic and socio-emotional development, and higher risks of failure and fall-out in schools. Studies have also shown that unidentified childhood hearing loss has historically been shown to dramatically deteriorate educational achievement and ultimately vocational outcomes. It has also been proven that minimal and unilateral permanent hearing losses result in poorer educational test performance, higher incidence of failed grades and greater dysfunction in areas such as behaviour, energy, stress, social support, self-esteem and socio-emotional aspects. The ability of children to hear is a significant contributory component towards their literacy and academic learning, and ultimately their vocational outcomes. In order to minimize and prevent a child's development from being delayed due to hearing deficiencies, it is imperative that reduced hearing sensitivity is identified at the earliest possible moment, so as to ensure that adequate interventions are timeously initiated.

Early identification of hearing impairment is however not only required in children, but also in adults and in particularly the elderly. Although it is not possible to restore ailing hearing sensitivity, intervention by way of a variety of hearing aids is possible. It is therefore also important to ensure that any loss in adult hearing sensitivity is detected at the earliest possible stage. This will ensure that discomfort and associated disadvantages caused by deficient hearing capabilities are addressed and minimised as early as possible.

Audiometric evaluations are often unavailable due to a shortage of hearing health care professionals, especially in developing countries. Audiometric evaluations are also often expensive and therefore often left neglected or unattended. A relatively brief screening procedure of hearing abilities however makes it possible to detect possible deficiencies, making it possible for patients testing below a certain threshold to be referred to an audiologist or other hearing expert to have a comprehensive audiometric and or medical evaluation. A disadvantage of known audiometers or screening devices is however that these devices are usually of a relatively substantial weight and size, making it cumbersome to transport from one location to the next. Furthermore, due to the relative complexity of existing audiometers, these audiometers are also fairly expensive, and it is therefore not desirable that these large and expensive devices are transported and moved at frequent intervals.

An additional disadvantage of known audiometers is that the operation of the audiometers requires a skilled and qualified technician or healthcare professional to operate it, which further emphasises the transport and affordability disadvantages detailed hereinabove.

A further disadvantage that is especially prevalent in resource scarce countries, is that the lack of adequate medical equipment and qualified operators thereof, are often a barrier to prevention, identification and treatment of manageable conditions such as reduced hearing sensitivity.

An even further disadvantage experienced with known audiometry systems is the interference of ambient noise with the hearing screening process, and the inability of known screening devices to measure the ambient noise level to determine whether or not it would interfere with the screening. OBJECT OF THE INVENTION

It is accordingly an object of the present invention to provide an audiometry system and method with which the above disadvantages could at least partially be overcome or alleviated.

SUMMARY OF THE INVENTION

According to a first aspect of the invention there is provided an audiometry system comprising:

a mobile device for transmitting a plurality of different predetermined signals representing predetermined sounds of different frequency and intensity;

at least one set of earphones provided with a receiver for receiving the signals, the earphones being responsive to the signals for emitting said predetermined sounds in accordance with the signals; and

an interface programmed to enable transmission of the signals from the mobile device to the earphones, and to determine and record the response of a user of the earphones to the emission of the respective sounds by the earphones in response to the signals. Further according to the invention, the predetermined sounds may be provided as calibrated pure tone signals calibrated by a calibration module according to specified standards. The predetermined sounds may also be provided as automated test sequences or pre-programmed test protocols that are specified according to a biographic profile of the user of the device.

Further according to the invention, the predetermined sounds consists of a selected set of frequencies to be tested followed by a selection of an intensity level, and wherein the set of frequencies fall within a range of 250 to 16 000 Hz and the intensity level fall within a range of 0 to 90 dB HL. The set of frequencies at the required intensity level may also correspond to the age of the user.

The interface is further programmed to capture and store information of the user and the response of the user on an internal or removal memory module of the mobile device.

The invention further provides for the mobile device to provide a visual or audio prompt to the user, after the sound has been emitted by the earphones worn by the user, the prompt requesting the user to respond by verifying whether the sound emitted by the earphones was or was not audible. The mobile device may communicate the response of the user to a remote data server via a wireless global system for mobile communications (GSM) network or over a Wi-Fi network to another Wi-Fi enabled device. The data may also be communicated via a wired network.

The invention further provides for the mobile device to be provided with an internal microphone configured to measure and monitor ambient noise levels before and during testing and the interface can be programmed to process the ambient noise levels and to alert a user, in the form of a visual feedback displayed on a screen of the mobile device, if the ambient noise level exceeds a maximum permissible ambient noise level corresponding to the frequency and intensity being tested. The internal microphone of the mobile device may also be configured to measure the sound emitted by the earphones and the interface may be yet further programmed to perform an internal calibration check to verify that the sound emitted by the earphones fall within a required intensity range. If the internal calibration check indicates an offset from the required intensity an adjustment to the signal intensity may be made automatically to ensure calibration is maintained.

The ambient noise level may further be continuously monitored during a screening at an octave band corresponding with the sound presented to the user.

The invention further provides for the the transmission of the signals from the mobile device to the receiver of the earphones to be a wireless transmission. The earphones may be selected from the group consisting of supra-aural headphones, circumaural headphones, insert earphones, and bone conducter transducers

In accordance with another aspect of the invention there is provided a method for performing a hearing screening using a mobile hearing screening device comprising the steps of:

providing an interface on a mobile device for determining and transmitting a sequence of signals representing predetermined sounds of different frequencies and intensities from the mobile device to a receiver of at least one set of earphones;

emitting a sequence of predetermined sounds from the earphones in accordance with the signals;

presenting the sequence of sounds to a first ear of the user wearing the earphones, and repeating the sequence of sounds to a second ear of the user;

capturing the user's response to each of the sounds in the sequence of sounds onto the mobile device;

comparing the user's responses to a pre-programmed screening criterion relating to frequency and intensity of the sounds via the interface; and

providing the user with the results of the screening. The results of the screening are provided on a display of the mobile device. The invention includes the further step of capturing a biographic profile of the user onto the mobile device before commencing with the screening.

The method may also include measuring the ambient noise level via an internal microphone of the mobile device to determine whether the ambient noise level exceeds a maximum permissible ambient noise level and/or measuring the sounds emitted by the headphones via the internal microphone and performing an internal calibration check to verify that the sounds fall within a required intensity range, and to adjust the intensity range if required.

The result of the screening may be transmitted to a remote data server.

BRIEF DESCRIPTION OF THE ACCOMPANYING DIAGRAMS

The invention will now be described further by way of a non-limiting example with reference to the accompanying diagrams wherein: figure 1 : is an illustrative view of an audiometric screening being performed by an audiometry system according to a preferred embodiment of the invention; and figure 2: is a schematic representation of the steps of the audiometric screening performed by the audiometry system of figure 1 , and the processing of results generated by the screening.

DESCRIPTION OF A PREFERRED EMBODIMENT OF THE INVENTION

Figure 1 shows an audiometry system and method according to a preferred embodiment of the invention.

The audiometry system consists of a mobile device 10 on which an interface (not shown) is programmed to enable the mobile device to transmit a plurality of different predetermined signals to the receiver of a set of earphones in the form of circumaural headphones 12 that emits, in response to the specific signals, predetermined sounds of a particular intensity and frequency to a user or screening subject 14 wearing the headphones 12. The interface that is programmed on the mobile device determines the signals transmitted by the mobile device 10 to provide intensities and frequencies of the sounds emitted by the headphones 12.

Health worker 16 operates the mobile device 10 during the screening of the hearing of screening subject 14. When the sound is played, the screening subject 14 indicates to the health worker that the sound emitted by the headphones 12 was audible to him/her, or that the sound was not heard. After the sound has been emitted, the interface causes a prompt to appear on the screen of the mobile device 10, which requires the health worker to indicate if the sound was or was not audible to the screening subject 12. The prompt is a simple yes or no response input on the mobile device which is done by pressing the key corresponding to the desired response, or by touching the screen of the mobile device where prompted to do so if the device 10 is provided with a touch screen.

The sound emitted by the headphones 12 is a pure tone sound at a certain frequency and intensity level that is determined by the biographies of the screening subject 14, with the main biographic factor being the age of the screening subject 14.

The sound is typically an automated test sequence of pure tones at three different frequencies that is first played on the one side of the headphones 12 to screen the hearing sensitivity of the one ear of the screening subject, and then repeated on the other side of the headphones 12 to screen the hearing sensitivity of the other ear of the screening subject. After each pure tone is played to the screening subject 14, the screening subject 14 indicates to the health worker 16 whether the particular pure tone was or was not heard. The pure tones are calibrated by a calibration module (not shown) according to international and national standards. The screening intensity of the pure tones that are emitted to a particular screening subject is typically determined by the age of the screening subject, and the acceptable hearing parameters for individuals falling in that particular age bracket. Children typically have a screening intensity criterion of 20 dB HL whilst adults may be at 25 or 30 dB HL.

For children, the three frequencies that are pre-programmed onto the device for purposes of a childhood screening are 1000Hz, 2000Hz and 4000Hz at 20 or 25 dB HL.

For adults, the three frequencies are typically 1000Hz, 2000Hz and 4000Hz at 25 or 30 dB HL.

Once the prompts in accordance with the screening subject's responses to the pure tones sequences are processed by the interface, the interface provides the health worker 16 with a recommendation or screening result. The recommendation or screening result may either be that the screening subject 14 has passed the screening, or that the screening revealed a reduced level of hearing sensitivity by the screening subject 14, and that the screening subject 14 should be referred to a qualified healthcare professional, which will in most instances be an audiologist.

The interface enables the screening of multiple screening subjects during a screening session at an educational facility or other institution where multiple screening subjects need to be screened. Accordingly, before commencing with the screening of the hearing of a particular screening subject, the health worker 16 captures biographic information of that screening subject, including name details, age, identification numbers and other pertinent information, on the mobile device. After capturing the biographic data of a screening subject, the screening is performed as discussed above, and the data of the subject is associated with the result of the screening. After a single screening or a batch of screenings during a screening session has been completed, the results of such screening or screenings are stored on an internal memory module within the mobile device (not shown), or on a removable memory module such as a USB memory card or SD memory card (or a miniature version of either of these memory cards).

After each screening, or after a batch of screenings, the screening results are transmitted to a remote data server 18 that is connected to a wireless global system for mobile communications (GSM) network 20 by a modem 22. The remote data server 18 may also be hosted in a cloud (not shown). If the mobile device 10 is in the vicinity of the remote data server 20, the results could be transferred by way of a Wi-Fi network, provided that both devices are Wi-Fi enabled. Alternatively, the removable memory module may be removed from the mobile device 10, and placed into a corresponding slot in the remote data server 20, from where the data can be copied and stored on the remote data server 20. The screening results may also be transmitted from the device to a server via a wired network. The results of the screening or batch of screenings that are stored on the remote data server 20 may subsequently be accessed from a remote location 24 by a healthcare professional, researcher or any other person having the required credentials and privileges to access the data held on the remote data server 20. By enabling results to be stored on a remote data server, and making the results accessible to various interested persons or parties, compliance with statutory and other requirements regarding hearing screening of the population before a certain age in childhood, and after a certain age in adulthood, and screenings at any other time or for whatever the reason, is obtainable or achieved.

An internal microphone (not shown) of the mobile device 10 is utilised to measure ambient noise levels (not shown). If the ambient noise is at such a level where it would cause the hearing screening to be inaccurate or compromised, the health worker or operator of the mobile device 10 is notified of the undesirable ambient noise level. This allows the health worker or other operator to take steps to prevent the unwanted effects of ambient noise on a hearing screening. The maximum permissible ambient noise level for testing at specific intensity and frequency combinations are specified by relevant national and international standards. The internal microphone is calibrated according to the standards required. To achieve this, the internal microphone of the mobile device must be calibrated alongside a Type 1 Sound Level Meter to ensure accurate environmental noise measurements are made by the device (not shown). As shown in figure 1 , the circumaural headphones may be wireless, but may also be connected to the mobile device by way of an audio jack that fits into a complimentary socket in the mobile device. It is also foreseen that circumaural headphones with ambient noise reducing capabilities may be used together with the mobile device. Circumaural headphones are used as it has inherent ambient noise reduction capabilities due to its construction of circular or ellipsoid earpads which completely surround the user's ears.

It is further also foreseen that the interface may further be programmed to perform an internal calibration check to verify that the sound emitted by the headphones fall within a required intensity range. This calibration check is performed by placing the internal microphone of the mobile device 10 approximate to the headset and initiating the calibration check sequence. Once calibration has been verified an automated correction may be made to adjust the signal output to adhere to calibration requirements.

The interface is in the form of an application that is programmable to a particular type of commercially available mobile device. A calibration constant is programmed for each type of mobile device, and is the same for all of the same or similar mobile devices. Although a mobile phone, and more particularly a Smartphone, would be the most practical mobile device for purposes of maintaining advantages brought about by the mobility of the screening device and method, it is also possible to program the interface to be suitable for use on any other type of computer device, including, but not limited to tablets, desktop computers and laptops. It is foreseen that the mobile device and headphones may be relatively low cost mobile devices and headphones that are commercially available, which eliminates the need to acquire expensive equipment for performing hearing screenings. As eluded to above, the only requirement of the mobile device is that it is capable of having the interface programmed or installed onto the mobile device, and for having the relatively simple functionality required to enable a user to perform a screening with the mobile device.

Figure 2 is a schematic representation of how to perform a hearing screening with the audiometry system, and of the processing of data that is generated when using the audiometry system and method. The representation is based on a three frequency screening protocol typically used for school-based hearing screening.

As indicated in figure 2, the process is commenced by an initial setup to ensure that the settings of the audiometry system are correct for the particular screening subject. These settings include the calibration of the mobile device; the selection of headphones; the setting of the screening intensity (volume of the screening); the setting of a presentation delay and the uploading of data to the remote server, database or cloud. After the initial setup has been done, the biographic data of the screening subject and the details of the facility where the screening is performed are entered into the mobile device. The data is then captured onto the internal or removable memory storage module of the mobile device, or it may be transmitted to the database, server or cloud.

Before the test commences, a measurement of the ambient noise level can be performed. If the ambient noise is above a permissible maximum level, then the ambient noise first has to be addressed by either silencing the source of the ambient noise, moving the location of the screening to a location that is more conducive to performing hearing screenings, or rescheduling the screening for a later time and/or date.

If the person performing the screening is satisfied that the ambient noise is at a permissible level, then the test continues. A pure tone is presented to either the left or the right ear of the screening subject. After the tone has been presented to the screening subject, the screening subject is asked whether or not the tone was audible. If the tone was not audible, the tone is again presented to the screening subject. The response of the screening subject to whether or not the tone was audible is captured onto the mobile device.

During testing the ambient noise is continuously monitored at an octave frequency band corresponding to the pure tone presented with visual feedback on whether the ambient noise is compliant with maximum permissible levels.

This process of presenting a screening subject with a tone and capturing the response is repeated three times in the first ear of the screening subject, each time at a different frequency, whereafter the three different tones are repeated a further three times in the other ear of the screening subject. Instead of repeating the tones three times for each ear consecutively, the tones could also be played to the first ear of the user, then to the second ear of the user, and then repeating the process three times (i.e. one sound per ear for each of the three selected frequencies).

Following the repetition of the process detailed above in both ears, the results are saved onto the internal or removable memory storage module of the mobile device, or it may immediately be communicated to the database, server or cloud. Alternatively, a batch of screening results may be transmitted to the database, server or cloud if multiple screenings are to be conducted on various screening subjects in a short space of time.

The invention can also be extended to include, as an additional component to the headphones, a USB powered bone conductor headphone device (not shown). This device is useful for evaluating hearing directly in the cochlea of the subject effectively bypassing the external and middle ear. The integration of such device in the audiometry system will be within the competence of a skilled person.

The audiometry system and method is useful in auditory threshold determination and screening of a subject at a pre-specified and frequency levels.

The disadvantage detailed above relating to hearing deficiencies being left undiagnosed and untended to due to the failure to perform hearing screenings due to the size, expense and unavailability of audiometric devices in resource scarce countries in particular, but also in developed countries, is accordingly at least partially overcome, due to the relatively small size and cost of the audiometry system according to the invention.

The disadvantage of known audiometric devices being relatively complex to operate and the need for having skilled and trained operators are alleviated due to the relative simplicity of the device.

The further disadvantage of ambient noise often affecting hearing screenings without the knowledge of the screening subject or the operator of known audiometric devices is also overcome due to the audiometry system of the invention being able to constantly monitor the ambient noise levels, and alerting the screening subject and/or operator or health worker if the ambient noise is at a level that may adversely affect the results of the screening. It is accordingly asserted that the disadvantages associated with known audiometric devices for performing hearing screenings could be overcome or at least alleviated with the audiometry system and method according to the invention.

It will be appreciated that in terms of the invention, variations in details are possible without departing from the scope of the appended claims.

Claims

1. An audiometry system comprising:

an interface programmed to enable transmission of the signals from the mobile device to the earphones, and to determine and record the response of a user of the earphones to the emission of the respective sounds by the earphones in response to the signals.

2. An audiometry system according to claim 1 , wherein the predetermined sounds are provided as calibrated pure tone signals calibrated by a calibration module according to specified standards.

3. An audiometry system according to claim 1 or 2, wherein the predetermined sounds are provided as automated test sequences or preprogrammed test protocols that are specified according to a biographic profile of the user of the device.

4. An audiometry system according to any one of claims 1 to 3, wherein the predetermined sounds consists of a selected set of frequencies to be tested followed by a selection of an intensity level.

5. An audiometry system according to claim 4, wherein the set of frequencies falls within a range of 250 to 16 000 Hz and the intensity level falls within a range of 0 to 90 dB HL.

6. An audiometry system according to claim 4 or 5, wherein the set of frequencies at the required intensity level corresponds to the age of the user.

7. An audiometry system according to claim 1 , wherein the interface is further programmed to capture and store information of the user and the response of the user on an internal or removal memory module of the mobile device.

8. An audiometry system according to claim 1 , wherein the mobile device provides a visual or audio prompt to the user, after the sound has been emitted by the earphones worn by the user, the prompt requesting the user to respond by verifying whether the sound emitted by the earphones was or was not audible.

9. An audiometry system according to claim 8, wherein the mobile device communicates the response of the user to a remote data server via a wireless global system for mobile communications (GSM) network or over a Wi-Fi network to another Wi-Fi enabled device.

10. An audiometry system according to any one of claims 7 to 9, wherein the mobile device is provided with an internal microphone configured to measure and monitor ambient noise levels before and during testing and wherein the interface is programmed to process the ambient noise levels and to alert a user, in the form of a visual feedback displayed on a screen of the mobile device, if the ambient noise level exceeds a maximum permissible ambient noise level corresponding to the frequency and intensity being tested and/or wherein the internal microphone of the mobile device is configured to measure the sound emitted by the earphones and wherein the interface is further programmed to perform an internal calibration check to verify that the sound emitted by the earphones fall within a required intensity range.

11. An audiometry system according to claim 10, wherein the ambient noise level is continuously monitored during operation at an octave band corresponding with the predetermined sound presented to the user.

12. An audiometry system accordingly to any one of claims 7 to 1 1 , wherein the mobile device is any device selected from the group consisting of mobile phones, tablets, laptops and desktop computers.

13. An audiometry system according to any one of the preceding claims, wherein the transmission of the signals from the mobile device to the receiver of the earphones is a wireless transmission.

14. An audiometry system according to any one of the preceding claims, wherein the earphones are selected from the group consisting of supra- aural headphones, circumaural headphones, insert earphones, and bone conducter transducers.

15. A method for performing a hearing screening using a mobile hearing screening device comprising the steps of:

presenting the sequence of sounds to a first ear of the user wearing the earphones, and repeating the sequence of sounds to a second ear of the user; capturing the user's response to each of the sounds in the sequence of sounds onto the mobile device;

providing the user with the results of the screening.

16. A method for performing a hearing screening according to claim 15, including the further step of providing the results of the screening on a display of the mobile device.

17. A method for performing a hearing screening according to claim 15 or 16, including the further step of capturing a biographic profile of the user onto the mobile device before commencing with the screening.

18. A method for performing a hearing screening according to any one of claims 15 to 17, including the further step of measuring an ambient noise level via an internal microphone of the mobile device to determine whether the ambient noise level exceeds a maximum permissible ambient noise level and/or measuring the sounds emitted by the headphones via the internal microphone, and performing an internal calibration check to verify that the sounds fall within a required intensity range, and to adjust the intensity range if required.

19. A method for performing a hearing screening according to any one of claims 15 to 18, including the further step of transmitting the result of the screening to a remote data server.

20. An audiometric system substantially as herein described and exemplified.

21. A method for performing a hearing screening substantially as herein described and exemplified.